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We have heard of people dying peacefully in their sleep, but it seems unlikely that this should happen to folks who are in their 30's.

But it does. And the odds of it happening increase dramatically if that person is also taking CNS depressants.

We have all heard about the tragic deaths of famous people like Brittany Murphy and Heath Ledger, both of who had a history of OTC pain meds in the weeks before they died, and both very young. We also heard about Philip Seymour Hoffman, who was a heroin abuser and somewhat obese.

I don't want to connect dots that aren't there, but if CNS depressants increase non-obstructive AHI event levels, or increase an event's severity, is it not possible that there is a direct connection to the likelihood of dying from them? There is also an epidemic of methadone deaths, which is probably because it builds tolerance quickly, meaning people take higher and higher doses to compensate, and then stop breathing.

We heard about those three actors dying before their time, and the only connection was use of CNS depressants. But the reason we heard about them is because they were famous. How about all of the ones we don't hear about who are not famous?

It seems that when someone dies in their sleep whenn on pain meds or OD's overnight on a CNS depressant, that is pegged as the sole cause. In reality, possibly sleep apnea is a contributing cause in many cases.

That said, it also seems that if you are being successfully treated for obstructive or non-obstructive apneas (are using CPAP) there is probably not any more risk in pain meds than to an untreated non-sufferer. Its just that there are always some risks, and more risks with pain meds than most other things.

Fairly new member... and fairly new to CPAP/APAP (but helped immensely by the amount of reading I've done on this site).

A recent personal experience with hydrocodone+ibroprofen for a dental implant confirms [for me] the tendency for increased central apneas. But there may be other factors with the CA's.

When I went for a sleep study using a CPAP, I realize now that my normal either-side sleeping positions didn't happen - my sub-conscious was aware of all of the %$#@!!! wires, so I slept mostly on my back.

As a result of the study, my original prescribed APAP pressure range was 8-16... I noticed that as I got used to sleeping with machine, Obstructives dropped, but Centrals were more stubborn. I then tried increasing the exhale pressure relief... some improvement in AHI. Got MAJOR improvement when I dropped the min. pressure to 6, and my curves all trended downward.

For me, it seemed like my body liked SOME positive pressure, but rebelled with too much. Lower pressures helped me drop many nights to an AHI of 2 and even lower, all with first 2 months of therapy.

Enter the pain meds... I was fairly lucky that my dental implant surgery was well away from any nerves, so I only took a lot of the hydrocodone+ibuprofen for first 24 hour period, half again the next day.

Curious about my numbers, I looked and found that centrals had spiked. (Phone call: my dental surgeon wasn't aware of possible interactions with sleep/apnea, but explained that the particular family of pain meds act like partial nerve blocks... so the nerve firing that helps trigger breathing could be suppressed). I was lucky to not need anything major at that point, drug-wise, and could switch to ibuprofen.

Moral of the story: I'd give high odds for ANY pain med (and I include alcohol ) to have some effects on your sleep. Depending on your sleeping position (back sleepers seem to require more pressure from what I've read), you might find that LOWER pressure[s] may be better for you.

If you can, use the info on your machine's SD card (hopefully, you have one) and software, and teach yourself about YOUR body...

Oh, and as a computer professional - big tip: after you remove the SD card from your machine, and BEFORE putting SD into computer slot/adapter/whatever, PLEASE slide the little switch on the card to the locked {read-only} position - this will prevent issues with your SD card when it is put back into machine. And don't worry, if you put in a card into the machine with write-protect on, you'll be nagged...

A dirty secret in the IT business is that most operating systems open a temporary file on whatever media they're allowed to... that disturbance in the force [technically, a change in the CRC checksum] may be detected by the machine, and the machine leaves you no choice but to format the card <sob> and you lose all of the info on the card... something that may be frowned on by your supplier/doctor/etc.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

KNOW what you are taking. I have suffered pain for several years and have chosen to remain on Percocet and Tylenol (not together as Percocet already has Tylenol in it).

Hydromorphone: Is a narcotic pain reliever that is related to the morphine family and is, in fact, 7.5 times as strong as morphine in similar quantity so know what you are being prescribed. I have a fractured vertebrae at present for which I am undergoing very sloooooow treatment (might be faster if I visited emerg and got admitted). I WAS taking Percocet (Oxycocet) on a regular basis and it was helping. The GP was concerned about the amount of Tylenol hitting my kidneys and changed me to Hydromorphone. I found that the Percocet worked far better and will hopefully return to it this Thursday - I dislike the Hydromorphone and do not believe it works as well unless you take a whack of it, which I will not do. It is highly and quickly addictive BTW.

There are a range of narcotic pain killers, many combined with Tylenol. The narcotic component is NOT to be messed with and you MUST be sure that your doctor knows that you are being treated for OSA. They WILL depress your respiration and I would strongly advise that you get yourself a recording pulse oximeter like the Contec CMS50EW and monitor your SpO2 during the night. If it is dropping below 89% you are in respiratory distress and your BP will shoot up. Not a happy place.

Be very wary of narcotic painkillers. Some are disasterous and almost instantly addictive.

Suggest you do a google search on narcotic pain medication for the lowdown.

----------------------------------------------------------------------------Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.

rjberube .. "Enter the pain meds... I was fairly lucky that my dental implant surgery was well away from any nerves, so I only took a lot of the hydrocodone+ibuprofen for first 24 hour period, half again the next day. "

What is the amount you state as "I only took a lot ?" and you don't state what strength hydrocodone+ibuprofen your prescription was for? . There are several strengths of Hydrocodone and differing amounts of ibuprofen with each strength.

I take one of the stronger Hydrocodone strength pills but it has the lowest amount of acetaminophen (325mg) for what is called breakout pain for a severe back injure I incurred back in 2001. It is used on top of regular pain medication I get through a skin patch I wear continuously and is much stronger then the hydrocodone..

I have mainly Centrals with very few obstructives, and am sure the pain medication has a direct link to them . and on top of all I am a back sleeper because of the pain I still endure . my pain levels remain in the 5-7 range on a 10 point scale ..

I am lucky (in Pain MGNT) that usually I can stay closer to a 3 or 4 most of the time. When I get to a '5' or higher I cannot focus on anything, reading, even TV - bout all I am good for is petting my dogs at that point.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."

I am lucky (in Pain MGNT) that usually I can stay closer to a 3 or 4 most of the time. When I get to a '5' or higher I cannot focus on anything, reading, even TV - bout all I am good for is petting my dogs at that point.

Mentally focusing with pain levels that high can be quite a task at times for some. Even though my main pain medication is 100 times more potent than morphine and many times more potent than heroin of the same amount, but I don't get that feeling of being unable to focus .. maybe because of the amount of time I have been on the drug or others like it.

Am sure my centrals are drug induced if not completely caused by them a large portion I believe are. Unable and unwilling to reduce pain medication leaves me no choice but to make the ResMed Adapt ASV work for me ..

One item that I added is a recording Oximeter, that also has an alarm function that can be set to go off if my blood O2 falls below XX level. It increases my wife's comfort level, and I wear it for a few days in a row anytime I have a med or dose change.

Sidenote: Saw my Ortho today, and looks like another surgery is upcoming in the near future, left shoulder repair this time. Oh Joy ☺

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."

I'm still trying to get an earlier appt. with my sleep medicine physician to get a new study for titration with ASV. My brain is really unhappy with all the nights of 30+ AHI (1/2 CA, 1/2 OA) on my current APAP.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.